Filing · f0633
Wellcare
Wellcare · Medicare Advantage · H0111 ·
In 2025 this plan received 12,773 standard prior authorization requests and denied 15.7% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
15.7%
12,773 standard requests, 2,000 denied.
94.3% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 12,773 | 10,773 | 2,000 | 15.7% |
| Expedited | 1,718 | 1,427 | 291 | 16.9% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 15.7%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 209 |
| Denials overturned | 197 |
| Overturn rate | 94.3% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 2.0 d |
| Expedited | 24.0 h | 24.0 h |